A case of sagittal splitting ramus osteotomy and genioplasty in a patient with congenital factor VII deficiency

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  • Rokutanda Satoshi
    Department of Oral and Maxillofacial Surgery, Imakiire General Hospital (Chief: Dr. Masashi Yoshida) Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences (Chief: Prof. Masahiro Umeda)
  • Yoshida Masashi
    Department of Oral and Maxillofacial Surgery, Imakiire General Hospital (Chief: Dr. Masashi Yoshida)
  • Kuroe Kazuto
    Kuroe Orthodontic Clinic (Chief: Dr. Kazuto Kuroe)
  • Yanamoto Souichi
    Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences (Chief: Prof. Masahiro Umeda)
  • Yamada Shin-ichi
    Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences (Chief: Prof. Masahiro Umeda)
  • Kawano Toshihiro
    Department of Oral and Maxillofacial Surgery, Imakiire General Hospital (Chief: Dr. Masashi Yoshida) Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences (Chief: Prof. Masahiro Umeda)
  • Naruse Tomofumi
    Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences (Chief: Prof. Masahiro Umeda)
  • Obama Kosuke
    Department of Hematology, Imakiire General Hospital (Chief: Dr. Kosuke Obama)
  • Umeda Masahiro
    Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences (Chief: Prof. Masahiro Umeda)

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Blood coagulation factor VII is involved in the extrinsic clotting system, and congenital defects or deficiencies affecting blood coagulation factor VII are rare. We report the case of a patient who was diagnosed with factor VII deficiency based on a preoperative examination and then underwent factor VII replacement therapy and orthognathic surgery, together with a brief discussion of the literature. 　The patient was a 25-year-old woman. She presented to our hospital after being diagnosed with jaw deformity and underwent sagittal splitting ramus osteotomy and genioplasty under general anesthesia. Preoperative tests revealed an abnormally short prothrombin time. Blood tests detected very low coagulation factor VII activity (33%), and so the patient was diagnosed with factor VII deficiency. 　We conducted preoperative factor VII replacement therapy to inhibit bleeding, and then the abovementioned surgical procedure was performed safely. The operative time was 1 hour 30 minutes, and little intraoperative blood loss occurred. The patient’s postoperative course was good, e.g., no abnormal bleeding occurred, and she was discharged on postoperative day 7.

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